Choking on an object is the situation in which whoever is present decides almost the whole outcome. But the first thing to do is not to give back blows — it is to look at whether the person can still cough, because treating the wrong group causes harm.
Recognising it: can they still cough hard or not
Partial obstruction and complete obstruction look different, and the way to handle them is the opposite. The quickest test: tell them to cough, or ask them a question. According to the American Red Cross, someone who can still speak, cry or cough forcefully is still moving air.
- STILL MOVING AIR — a cough that makes a sound, a forceful one; still able to speak or cry. Encourage them to keep coughing, tell them to spit it out if the object reaches the mouth, and stand beside them without taking your eyes off them.
- COMPLETELY BLOCKED — no sound at all, no speech, no crying; only a faint whistle, or silence; hands clutching at the throat; lips and fingertips blue or grey.
The easiest mistake is trusting the noise: someone partly obstructed breathes noisily, sometimes with a frightening whistle, but can still cough. Someone completely blocked is silent. For a child learning to eat, NHS sums it up: gagging is NOISY, choking is SILENT.
What to do when the person is completely blocked
Ask whoever is next to you to call 115 (the emergency number in Vietnam) while you work — the call and the first aid run in parallel. If you are on your own, act first; according to NHS, if back blows and abdominal thrusts have not cleared it, call 115 straight away.
Adults and children over one year old
- Stand behind them, slightly to one side. Support the chest with one hand and lean them forward — so the object falls out of the mouth rather than further down.
- Use the HEEL OF YOUR HAND to strike firmly and sharply between the shoulder blades. After each series, look in the mouth to see whether the object has come out.
- If it has not, give ABDOMINAL THRUSTS: put both arms around the abdomen, lean them forward; place one clenched fist just above the navel, the other hand over it, and pull sharply inwards and upwards.
- Alternate back blows and abdominal thrusts until the object comes out, until they can cough forcefully and speak, or until they lose consciousness.
Babies under one year old
- Lay the baby face down along your forearm or across your thigh, head lower than the body; one hand supporting the chest and holding the jaw gently.
- Strike firmly between the shoulder blades with the heel of your hand.
- If it has not come out, turn the baby onto their back, place two fingers in the middle of the chest, below the line between the nipples, and push firmly and sharply down — chest thrusts.
- Alternate those two. NEVER give abdominal thrusts to a baby under one — NHS states plainly that they must not be used.
Anyone pregnant, anyone too large to reach around
No abdominal thrusts here either: NHS states plainly that abdominal thrusts must not be used on a pregnant woman. The Red Cross guidance is to give CHEST thrusts — placing the hands in the middle of the chest instead of above the navel — when the person is pregnant, when you cannot get your arms around their abdomen, or when they are in a wheelchair. Back blows are given as usual.
Things you must NOT do
- Do NOT put fingers into the mouth to feel around when you cannot see the object clearly — NHS says this can make things worse by pushing the object further in.
- Do NOT give back blows to someone who is coughing hard and standing up on their own. Their own cough is more effective than anything you can do; interrupting it can turn a partial obstruction into a complete one.
- Do NOT give water or more food to make the object “go down”. The object is in the airway, not in the food pipe; giving a drink to someone who cannot breathe puts water into the lungs.
- Do NOT hold a child upside down and shake them, do not squeeze or manipulate the neck, do not waste time on coin rubbing and balm or on finding someone with more experience.
When you must go to hospital
CALL 115 NOW — no waiting, no trying something else — if: there is no sound at all, no speech, no crying, no cough possible; only a faint whistle and then silence; the lips, face or fingertips are blue, grey or pale; back blows and abdominal thrusts have not cleared it; the person is unconscious or has stopped breathing. — BE SEEN THE SAME DAY, even though the object has come out and the person looks fine, if: abdominal thrusts had to be used; a cough persists; there is still a feeling of something caught in the throat; a child is suspected of having inhaled or swallowed a small object even though the coughing has now stopped. A suspected swallowed button battery means emergency care, do not wait. — Be seen within 24–72 hours if: an older person often coughs and chokes while eating or drinking, or their voice sounds wet after a drink.
Abdominal thrusts can cause injury inside the abdomen, which is why NHS requires anyone who has been given abdominal thrusts to be checked over by a doctor, even when the object has come out.
A button battery is an emergency of its own: it lodges and then corrodes a hole through the gullet or the windpipe. Go to emergency care at once, say clearly that a battery may have been swallowed, give nothing to eat or drink, and do not make them vomit.
Prevention is the cheapest part
According to CDC, cutting food up small and mashing it soft helps prevent choking; CDC names whole grapes and cherry tomatoes, whole nuts and seeds, sausages, popcorn, hard sweets and sticky sweets, and also advises sitting children upright to eat and keeping an eye on them throughout the meal. Around the house, keep buttons, marbles, small magnets and button batteries up high.
An unconscious person is an entirely different situation: according to NHS, if they lose consciousness and are not breathing, CPR has to be started — a skill that must be learned with your hands, not from text. NHS advises taking a first aid course.
A blocked airway has no home remedy that replaces getting the person to somewhere the object can be removed — with a sign in the box above, go in first and ring afterwards. Our role is at either end: a remote consultation when you are not sure whether hospital is needed, and a doctor coming to the house to examine an older person who often coughs and chokes while eating.
A note on sources: the CDC page on this subject is about preventing choking and does not give first aid technique — CDC itself advises asking a doctor or nurse what to do if a child chokes. So the technique here passes on the guidance of NHS and of the American Red Cross. Citing CDC does not imply that CDC endorses Y Te Xanh or our services; this article does not replace being examined in person.
Need personalised advice for your loved one? Call our hotline 094 368 81 15 (24/7) — calling to ask a question or to book costs nothing. GreenCare has doctors who come to examine, nurses who carry out doctor's orders (injections, infusions, dressing changes), remote consultation by video call, and a review of the medicines you are taking; an in-depth remote consultation, or any one after the first, is a paid service. For children we take examination and acute care only — not long-term care at home, and not newborns or expectant mothers. We confirm we have staff in your area and provide transparent pricing before we begin.
Sources
- NHS — Dysphagia (swallowing problems)
- CDC — Choking Hazards
